ORAL HEALTH INTERVENTIONS AND TREATMENTS FOR OLDER ADULTS WITH COGNITIVE IMPAIRMENT AND DIABETES

Abstract Older adults with cognitive impairment or diabetes have a higher risk of poor oral health. It is therefore critically important to develop effective intervention strategies to improve oral health for these vulnerable populations. In this session, we have included three studies that aim to achieve this goal using different strategies. The first study used stakeholder engaged processes to develop an app that provides information and guidance to caregivers (i.e., paid and family caregivers) to support their oral care provision for older adults with dementia. Findings from this study show that the app was well-accepted and provided an easily accessible tool for caregivers during care provision. The second study aimed to improve oral hygiene outcomes (plaque index and gingival index) for individuals with mild cognitive impairment (MCI) or mild dementia (MD). In this study, the authors identified and compared active behavior change techniques (BCT) used in a care partner-assisted oral health intervention for individuals with MCI and MD using a qualitative, secondary analysis of coaching sessions with care partners. Findings from this study provide insight into the mechanisms of change in individuals’ behaviors using these interventions. The third study was a systematic review aiming to explore the age differences in the effect of multi-component periodontal treatments on oral and metabolic indicators among individuals with periodontitis and diabetes. This study identified 115 eligible trials. This study found that the effect of multi-component periodontal treatments on periodontal outcomes and HbA1c may be more effective among younger populations. This is an Oral Health Interest Group Sponsored Symposium.

United States, 2. Benjamin Rose Institute on Aging, Cleveland, Ohio, United States, 3. Tufts University School of Medicine,Boston,Massachusetts,United States,4. Canopy Consultants Inc.,Arlington,Massachusetts,United States There are over 1 million hospital admissions and 3 million emergency room visits for heart failure (HF) annually in the USA.Despite significant impact of HF on both members of the care dyad, there are few interventions focused on optimizing the mental and relational health of the dyad.The Taking Care of Us© (TCU) intervention is a communication-based program for the couple living with HF.Sessions focus on facilitating greater shared appraisal, communication, collaborative illness management, confidence, and support between partners.Thirty seven couples were randomized to TCU (18 couples) or an educational control (19 couples).Both programs were delivered virtually over two months.Adults with HF (AwHF) were, on average, 69.9 (SD=9.6)years old and predominantly male (70%).Eighty one percent of couples participated in at least one session (attrition was relatively even across conditions and primarily due to poor health and partner drop-out).Twenty-four couples (65%) completed follow-up surveys.The majority of TCU participants were satisfied with the program (AwHF 82%; care partners 100%) and felt they understood their partner's needs better (AwHF 91%; care partners 91%).TCU care partners felt the relationship had improved (91%) and felt more confident managing HF (91%).Depressive symptoms decreased in TCU AwHF (ES=.60)compared to the active control group.TCU couples also reported increases in collaboration (ES=.50-.70) and communication ).Discussion will focus on the individual versus dyadic benefits of the TCU program, recruitment and retention challenges, and qualitative feedback from participants regarding strengths of the program and areas for improvement.

ORAL HEALTH INTERVENTIONS AND TREATMENTS FOR OLDER ADULTS WITH COGNITIVE IMPAIRMENT AND DIABETES
Chair: Stephen Shuman Co-Chair: Bei Wu Discussant: Michele Saunders Older adults with cognitive impairment or diabetes have a higher risk of poor oral health.It is therefore critically important to develop effective intervention strategies to improve oral health for these vulnerable populations.In this session, we have included three studies that aim to achieve this goal using different strategies.The first study used stakeholder engaged processes to develop an app that provides information and guidance to caregivers (i.e., paid and family caregivers) to support their oral care provision for older adults with dementia.Findings from this study show that the app was well-accepted and provided an easily accessible tool for caregivers during care provision.The second study aimed to improve oral hygiene outcomes (plaque index and gingival index) for individuals with mild cognitive impairment (MCI) or mild dementia (MD).In this study, the authors identified and compared active behavior change techniques (BCT) used in a care partner-assisted oral health intervention for individuals with MCI and MD using a qualitative, secondary analysis of coaching sessions with care partners.Findings from this study provide insight into the mechanisms of change in individuals' behaviors using these interventions.The third study was a systematic review aiming to explore the age differences in the effect of multi-component periodontal treatments on oral and metabolic indicators among individuals with periodontitis and diabetes.This study identified 115 eligible trials.This study found that the effect of multi-component periodontal treatments on periodontal outcomes and HbA1c may be more effective among younger populations.This is an Oral Health Interest Group Sponsored Symposium.

AGE DIFFERENCES IN THE EFFECTS OF PERIODONTAL TREATMENTS ON ORAL AND METABOLIC HEALTH IN PEOPLE WITH DIABETES
Zheng Zhu, Xiang Qi, Yaguang Zheng, Yaolin Pei, and Bei Wu, New York University, New York City, New York,

United States
Background: This systematic review aims to explore the age differences in the effect of multi-component periodontal treatments on oral and metabolic indicators among individuals with periodontitis and diabetes.
Methods: Six databases were searched from database inception to August 2022.Trials reporting the effects of multi-component periodontal treatments on oral and metabolic indicators among participants aged 18 and above with periodontitis and diabetes were included.We used bivariate and multivariate meta-regression models to examine the association between age and treatment effect size.The primary outcomes were changes in probing depth (PD), clinical attachment level (CAL), and hemoglobin A1c (HbA1c).
Conclusions: The effect of multi-component periodontal treatments on PD, CAL, and HbA1c may be more effective among younger populations.Our study suggests that tailored interventions are needed to improve oral health and diabetes management for individuals with periodontitis and diabetes.

BEHAVIOR CHANGE TECHNIQUES IN PERSONS WITH MCI AND MD AND THEIR CARE PARTNERS: A REPORT OF AN ORAL HEALTH INTERVENTION
Ashley Bryant 1 , Youngmin Cho 2 , courtney caiola 3 , Donald Bailey 4 , Brenda Plassman 4 , Bei Wu 5 , and Ruth Anderson 2 , 1.The University of North Carolina at Chapel Hill,Chapel Hill,North Carolina,United States,2. University of North Carolina at Chapel Hill,Chapel Hill,North Carolina,United States,3. East Carolina University,Greenville,North Carolina,United States,4. Duke University,Durham,North Carolina,United States,5. New York University,New York City,New York,United States Older adults with cognitive impairment are likely to experience a decline in oral health and hygiene, which can have profound negative impacts such as cavities, gum disease and tooth loss.Poor oral health is also linked to adverse health outcomes including diabetes, cardiovascular disease, and aspiration pneumonia.Despite these factors, inadequate oral hygiene practices provided by formal and informal care partners may contribute to poor oral hygiene.In this study, we aimed to improve oral hygiene outcomes (plaque index and gingival index) for individuals with mild cognitive impairment (MCI) or mild dementia (MD) by fostering behavior changes among care partners trained to assist them.We identified and compared active behavior change techniques (BCT) used in a care partnerassisted oral health intervention for individuals with MCI and MD using a qualitative, secondary analysis of coaching sessions with care partners (n=17 dyads: 10 dyads for MCI, 7 dyads for MD).Frequently used BCTs in both MCI and MD groups were prompts and cues, instruction on how to perform the behavior, review behavioral goal, and problem solving.Common BCTs were found across both MCI and MD groups that provide clarity on the active components for behavior change.Social support-unspecified emerged for MCI group and credible source emerged for MD group.In this intervention, BCTs were focused on oral health, however BCTs can assist in addressing multiple types of behavior change.Findings from this study provide insight into the mechanisms of changes in individuals' behaviors using these interventions.